­Call for urgent action to fix arthritis crisis

The number of adults with ­arthritis waiting for joint replacements has exploded in recent years, prompting calls for greater preventive healthcare.

The number of Australians with arthritis is expected to rise rapidly from 3.6 million today to 5.4 million by 2030. Picture: iStock

The number of adults with ­arthritis waiting for joint replacements has exploded in recent years, prompting calls for greater preventive healthcare, while children and teens with the debilitating condition are struggling to get treated.

A critical shortage of paediatric rheumatologists is causing signif­icantly delayed diagnosis of ­arthritis in many children, triggering a call for a tripling in the numbers of healthcare practitioners to cater for the 6000-10,000 Aus­tralian patients with juvenile ­arthritis.

There are only 13 clinical full-time equivalent paediatric rheumatologists in Australia to treat all of these children aged up to 16 years old. The Juvenile Arthritis Foundation Australia said that has meant about 43 per cent of kids with juvenile arthritis have no access to a specialist at all, while 80 per cent of patients live with significant pain.

“Australia’s health services for juvenile arthritis remain well below international standards, and well below Australian standards for other similarly serious and prevalent childhood diseases,” associate professor Ruth Colagiuri, founder of Juvenile Arthritis Foundation Australia, said. “It’s grossly underfunded, services are very thin on the ground, and it’s especially difficult for ­people in rural and regional areas.”

The number of Australians with arthritis is expected to rise rapidly from 3.6 million today to 5.4 million by 2030, leading to significant pressure on the health system. The disease will lead to 800,000 hospitalisations this year alone – 7 per cent of the total.

Yet musculoskeletal condit­ions including arthritis receive a fraction of the funding of cardiovascular disease and mental health, which carry similar disease burdens. Funding is now at its lowest level in a decade.

“We are reaching a tipping point where these already high costs will skyrocket in coming years with an ageing population and rising obesity levels,” said ­Arthritis Australia chief executive Jonathan Smithers.

“The health system is spending huge amounts of money on joint replacements, some of the most expensive items in the health budget, and still struggling to keep up with demand. To reduce rising cost to the health system, we need to fund more of the preventive programs that we know work.”

There are more than 100 different types of arthritis, and the disease can have an inflammatory cause such as in rheumatoid ­arthritis, an auto-immune condition, or a non-inflammatory cause, such as osteoarthritis, in which the joints degrade later in life. The disease costs the health system $14bn every year.

People with arthritis are able to access only five sessions with an allied health practitioner a year under Medicare-subsidised chronic disease plans.

Sydney orthopaedic surgeon Ian Harris said access to earlier intervention for arthritis patients was an urgent priority, with the cost of hip and knee replacement alone expected to cost more than $5bn a year within a decade.

“Many costly joint replacement surgeries would simply not be necessary if earlier intervention was available to all Australians,” Professor Harris said.

Osteoarthritis sufferer Julie Clark, 60, had to have both hips replaced in recent years. Her family doesn’t have private health insurance and after waiting more than two years on the public hospital waiting list for surgery, she was in such agonising pain that she had to borrow against equity in her house to pay for surgery privately. “It’s a lifestyle management situation that really needs to be grabbed a hold of very early on,” Ms Clark said.

Arthritis Australian and the JAFA are seeking immediate action including funding to urgently increase the juvenile arthritis workforce, an expanded rollout of a national surgery catch-up package, and a big injection of funding into arthritis research.